Justice, Larry T
Justice, Larry T is an individual health care provider with primary practice located at 80 Vermont Ave , Oak Ridge TN 37830-6474. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Interventional Cardiology, Allopathic & Osteopathic Physicians / Cardiovascular Disease. Allopathic & Osteopathic Physicians / Cardiovascular Disease is his primary health care specialty. Justice, Larry T can be contacted via phone (865) 482-4078.Contact Information
Primary practice address
80 Vermont Ave
Oak Ridge TN 37830-6474
Phone: (865) 482-4078
Fax: (865) 482-4960
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Interventional Cardiology | 207RI0011X | 40574 | Tennessee |
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 40574 | Tennessee |
Profile Details
| NPI number | 1790721819 |
|---|---|
| LBN Legal business name | Justice, Larry T |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 20th, 2006 |
| Last updated | Sep 18th, 2020 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1790721819 | NPPES |
| Tennessee | MEDICAID | 3338151 | |
| Tennessee | Other | 4125100 | |
| Tennessee | Other | 7100065540 | |
| Tennessee | MEDICAID | Q009959 | |
| Tennessee | MEDICAID | 3379860 |
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